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Review
. 2022 Sep 4;10(9):1466.
doi: 10.3390/vaccines10091466.

Cost-Effectiveness of Intranasal Live-Attenuated Influenza Vaccine for Children: A Systematic Review

Kenneth Sik-Kwan Chan  1 , Charlene Hoi-Lam Wong  1 , Horace Cheuk-Wai Choi  2   3
Affiliations
Review

Cost-Effectiveness of Intranasal Live-Attenuated Influenza Vaccine for Children: A Systematic Review

Kenneth Sik-Kwan Chan et al. Vaccines (Basel). .

Abstract

Introduction: The public health burden of seasonal influenza is significant, and influenza vaccination is the most effective preventive strategy. Nonetheless, the recommendation of influenza immunization in the pediatric population is still underrepresented. Our work aimed to assess the cost-effectiveness of pediatric influenza vaccination with the intranasal live-attenuated influenza vaccine (LAIV).

Methods: We performed a systematic review of publications from PubMed/MEDLINE, Embase, and Scopus, covering the period from 1 January 2000 to 30 April 2022. We searched for economic evaluations that studied the impacts of LAIV among children or the pediatric population. Studies that considered incremental cost-effectiveness ratios (ICERs), in terms of cost per gain in life years, quality adjusted life years, or disability-adjusted life years, were covered. The Consensus Health Economic Criteria (CHEC) Extended Checklist was adopted to check the quality of the included studies.

Results: Thirteen studies were included for the final review that were of good or excellent quality. The implementation of influenza vaccination with intranasal LAIV in the pediatric population was cost-effective when compared to the immunization strategies for the elderly and the high-risk groups alone or with no vaccination. The efficacy of LAIV for children, vaccination coverage, and the vaccine price were significant factors to the cost-effectiveness of influenza vaccination for children. Another significant contribution to the cost-effectiveness was the herd immunity arising from pediatric immunization against influenza.

Conclusions: The implementation of influenza vaccination in the pediatric population with LAIV is cost-effective. Policymakers and health authorities may consider the evidence on the development of the pediatric influenza vaccination in their immunization schedules.

Keywords: economic evaluation; live-attenuated influenza vaccine (LAIV); pediatric vaccination.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The literature search flow diagram.
Figure 2
Figure 2
Incremental cost-effectiveness ratios against vaccine prices. Abbreviations: ICER—increment cost-effectiveness ratio; LAIV—live-attenuated influenza vaccine.
See this image and copyright information in PMC

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References

    1. Iuliano A.D., Roguski K.M., Chang H.H., Muscatello D.J., Palekar R., Tempia S., Cohen C., Gran J.M., Schanzer D., Cowling B.J., et al. Estimates of global seasonal influenza-associated respiratory mortality: A modelling study. Lancet. 2018;391:1285–1300. doi: 10.1016/S0140-6736(17)33293-2. - DOI - PMC - PubMed
    1. World Health Organization Influenza. 2022. [(accessed on 20 July 2022)]. Available online: https://www.who.int/teams/health-product-policy-and-standards/standards-....
    1. Wang X., Li Y., O’Brien K.L., Madhi S.A., Widdowson M.-A., Byass P., Omer S.B., Abbas Q., Ali A., Amu A., et al. Global burden of respiratory infections associated with seasonal influenza in children under 5 years in 2018: A systematic review and modelling study. Lancet Glob. Health. 2020;8:e497–e510. doi: 10.1016/S2214-109X(19)30545-5. - DOI - PMC - PubMed
    1. Putri W.C., Muscatello D.J., Stockwell M.S., Newall A.T. Economic burden of seasonal influenza in the United States. Vaccine. 2018;36:3960–3966. doi: 10.1016/j.vaccine.2018.05.057. - DOI - PubMed
    1. Antonova E.N., Rycroft C.E., Ambrose C.S., Heikkinen T., Principi N. Burden of paediatric influenza in Western Europe: A systematic review. BMC Public Health. 2012;12:968. doi: 10.1186/1471-2458-12-968. - DOI - PMC - PubMed

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